PubMed Health⌕ Search

Biomedical subjects

D C McKee

Publications and source records attributed to D C McKee.

At least 19 recordsLinked to original sources
PubMed1996

Building blocks. Roundtable discussion.

Former Hospitals & Health Networks executive editor Mark Hagland and Health Facilities Management editor Kurt Luchs and associate editor Catherine Quayle recently hosted a roundtable discussion on design and construction issues in health care. They wanted to know what health care senior executives and experts in the design and construction field thought about today's most pressing issues and biggest trends. Hagland and Luchs assembled a group or experts and executives in Chicago and set the tape rolling. Here are excerpts from the discussion.

Decision Making, Organizational↗
PubMed1991

Long-term effects of exercise on psychological functioning in older men and women.

The purpose of this study was to determine the psychological, behavioral, and cognitive changes associated with up to 14 months of aerobic exercise training. For the first 4 months of the study, 101 older (greater than 60 years) men and women were randomly assigned to one of three conditions: Aerobic exercise, Yoga, or a Waiting List control group. Before and following the intervention, all subjects completed a comprehensive assessment battery, including measures of mood and cognitive functioning. A semi-crossover design was employed such that, following completion of the second assessment, all subjects completed 4 months of aerobic exercise and underwent a third assessment. Subjects were given the option of participating in 6 additional months of supervised aerobic exercise (14 months total), and all subjects, regardless of their exercise status, completed a fourth assessment. Results indicated that subjects experienced a 10-15% improvement in aerobic capacity. In general, there were relatively few improvements in cognitive performance associated with aerobic exercise, although subjects who maintained their exercise participation for 14 months experienced improvements in some psychiatric symptoms. However, the healthy subjects in this study were functioning at a relatively high level to begin with, and exercise training may produce greater improvements among elderly with concomitant physical or emotional impairments.

Affect↗
PubMed1990

Neuropsychological effect of lead in occupationally exposed workers: a critical review.

In their discussion of field testing of health effects of environmental and industrial toxins, Gullion and Eckerman make the following observations which can be applied to the current literature survey: "The general inattention to methodological consistency makes it difficult to integrate the research to date into a clear picture of what is known and not known about the effects of toxic substances on human behavior. In view of the variation in methods of subject selection, measurement, and statistical analysis, the completion of a series of studies of a particular toxic substance does not assure that there has been a concurrent accumulation of reliable knowledge about the effects of that substance. Apparent replications or failures to replicate a significant relationship must be evaluated carefully, since different studies may have measured different things in different populations." Therefore, the issue of psychological and neuropsychological effects of low-level lead exposure in adults remains to be resolved in the studies reviewed. The methodologies were so varied and the cultures in which the studies were conducted so diverse that it is impossible to generalize across findings. For example, studies were conducted in the U.S., Denmark, Sweden, Finland, and Australia. Although, in some instances, equivalent versions of neuropsychological and psychological tests were used, this was generally not the case. Nevertheless, a few general statements can be made. Studies that have been carried out in recent years are beginning to pay attention to more methodology and therefore do a much better job of controlling for possible confounding variables. Also, their statistical methods are more sophisticated and reporting techniques are superior to the earlier investigations in this area. The issue of whether current blood lead levels or cumulative levels are preferable is still unresolved with regard to the relationship of neuropsychological impairment. In the area of psychosocial functioning, there appears to be at least some evidence to support the observation that increased irritability and fatigue may lead to the interpersonal problems noted in various studies. However, this observation may be related to other factors which have not been controlled for, such as the workers' attitudes toward their job, level of motivation, and overall level of mental health. With regard to neuropsychological functions, there is some suggestive preliminary evidence for subtle changes in the ability to process information quickly.(ABSTRACT TRUNCATED AT 400 WORDS)

Behavior↗
PubMed1989

Cardiovascular and behavioral effects of aerobic exercise training in healthy older men and women.

The cardiovascular and behavioral adaptations associated with a 4-month program of aerobic exercise training were examined in 101 older men and women (mean age = 67 years). Subjects were randomly assigned to an Aerobic Exercise group, a Yoga and Flexibility control group, or a Waiting List control group. Prior to and following the 4-month program, subjects underwent comprehensive physiological and psychological evaluations. Physiological measures included measurement of blood pressure, lipids, bone density, and cardiorespiratory fitness including direct measurements of peak oxygen consumption (VO2) and anaerobic threshold. Psychological measures included measures of mood, psychiatric symptoms, and neuropsychological functioning. This study demonstrated that 4 months of aerobic exercise training produced an overall 11.6% improvement in peak VO2 and a 13% increase in anaerobic threshold. In contrast, the Yoga and Waiting List control groups experienced no change in cardiorespiratory fitness. Other favorable physiological changes observed among aerobic exercise participants included lower cholesterol levels, diastolic blood pressure levels, and for subjects at risk for bone fracture, a trend toward an increase in bone mineral content. Although few significant psychological changes could be attributed to aerobic exercise training, participants in the two active treatment groups perceived themselves as improving on a number of psychological and behavioral dimensions.

Aged↗
PubMed1988

Psychosocial factors in the irritable bowel syndrome. A multivariate study of patients and nonpatients with irritable bowel syndrome.

In this multivariate analysis of the irritable bowel syndrome (IBS) we describe the symptomatic and psychologic features of the condition and their possible contributions to health care seeking. We studied 72 IBS patients, 82 persons with IBS who had not sought medical treatment, and 84 normal subjects. All subjects received complete medical evaluation, diary card assessment of abdominal pain and stool habit, and standard psychologic tests of pain, personality, mood, stressful life events, illness behavior, and social support. Pain and diarrhea were the most important symptoms associated with patient status. When controlling for these symptoms we found that (a) IBS patients have a higher proportion of abnormal personality patterns, greater illness behaviors, and lower positive stressful life event scores than IBS nonpatients (p less than 0.001) and normals (p less than 0.001); (b) IBS nonpatients, although psychologically intermediate between patients and normals, are not different from normals (p less than 0.21); and (c) IBS nonpatients have higher coping capabilities, experience illness as less disruptive to life, and tend to exhibit less psychologic denial than patients. These factors may contribute to "wellness behaviors" among people with chronic bowel symptoms. We conclude that the psychologic factors previously attributed to the IBS are associated with patient status rather than to the disorder per se. These factors may interact with physiologic disturbances in the bowel to determine how the illness is experienced and acted upon.

Adult↗
PubMed1988

Short-term behavioral effects of beta-adrenergic medications in men with mild hypertension.

beta-Adrenergic-inhibiting drugs are widely prescribed for the treatment of hypertension. These drugs have previously been found to influence a variety of psychologic and behavioral functions and have, in some cases, been associated with serious psychiatric side effects. The present study examined psychologic changes associated with beta-blockade therapy. Twenty-six men with mild hypertension (diastolic blood pressure 90 to 110 mm Hg) were randomly assigned to receive either a selective beta 1-antagonist (atenolol), a nonselective beta 1- and beta 2-antagonist (propranolol), or a placebo. Both before and after a 2-week period of drug administration, subjects completed a comprehensive assessment of quality of life including measures of mood, memory performance, and side effects. In general, beta-blocker therapy was associated with relatively few adverse symptoms, particularly when compared with control subjects taking placebo. Reductions in negative emotional states (tension and anger) were observed for subjects receiving atenolol, and the largest improvements in memory performance were observed for subjects receiving propranolol. These results suggest that beta-blocker therapy is not invariably associated with negative side effects and that some behavioral functions may actually be improved.

Adult↗
PubMed1987

Recollection of childhood events in adults with irritable bowel syndrome.

We examined retrospectively premorbid factors that might relate to the development of irritable bowel syndrome (IBS). We administered a semistructural interview to adult IBS patients, adults with symptoms of IBS who had not visited a doctor (nonpatients), and asymptomatic normals. Patients with IBS differed from nonpatients by reporting more severe bowel problems, more frequent doctor visits in childhood, and more pain associated with current bowel symptoms. These factors may contribute to the tendency of people with bowel symptoms to seek medical care. More patients, and in most cases nonpatients with IBS, reported poorer general health and headaches, stomachaches, and bowel complaints during childhood. They also showed evidence for greater parental attention to illness with more frequent school absences and doctor visits than normal subjects. Loss and separation during childhood, and in the current family, and conflicted or dependent maternal relationships were also more frequently reported among patients and nonpatients. These factors may contribute to the development of IBS.

Adult↗
PubMed1986

Memory performance by mild hypertensives following beta-adrenergic blockade.

Previous experiments have reported deficits in cognitive performance following the administration of beta-adrenoceptor antagonists. These deficits have not appeared consistently, however, and it is not clear from previous studies whether changes in the central nervous system, rather than end-organ functioning, are responsible. The present experiment investigated the effects of beta blockade in a memory-search paradigm that distinguished the relatively central process of memory comparison from the more peripheral processes of stimulus encoding and response selection. Twenty-six adult men with mild essential hypertension received either a placebo or a beta blocker (atenolol or propranolol) for 2 weeks. Although beta blockade did occur in the active drug groups, there were no significant effects of the drugs on memory-search performance.

Adult↗
PubMed1986

Urgency and fecal soiling in people with bowel dysfunction.

The frequency of urgency and fecal soiling in the population and among people with irritable bowel syndrome (IBS), and the association of these symptoms with health care seeking is unknown. Among 1128 students and hospital employees that we surveyed, urgency was reported in 14.4%, fecal soiling in 5.3%, and diarrhea in 9.0%. Most persons with fecal soiling did not report urgency or diarrhea. Although bowel dysfunction compatible with IBS was present in 20% (227), only 29% of this group (65) had seen a physician for bowel complaints. People with bowel dysfunction were more likely to be women, to take laxatives, and to have rectal urgency. Fecal soiling was more likely among those with bowel dysfunction who had been to the doctor, and included almost half of the men in this group. There was no difference in the frequency of diarrhea reported among those with bowel dysfunction regardless of whether they had been to the doctor. These data suggest fecal soiling may influence people with bowel dysfunction to go to the doctor. Physiological studies are needed to determine if anal sphincter dysfunction is a component of IBS.

Cathartics↗
PubMed1985

Life adaptation after percutaneous transluminal coronary angioplasty and coronary artery bypass grafting.

Life adaptation of 32 patients who had undergone percutaneous transluminal coronary angioplasty (PTCA) for coronary stenosis was compared with that of 15 patients who had coronary artery bypass grafting (CABG). Patients were matched for psychosocial, anatomic and cardiac functions. Life adaptation was measured at 6 and 15 months after PTCA or CABG by the Psychosocial Adjustment to Illness Scale (PAIS), a multidimensional instrument that evaluates change in 7 primary life domains. The overall PAIS scores for patients who had undergone PTCA were significantly better (p less than 0.04) than the scores for those who had undergone CABG after 6 months, and this superior functioning continued after 15 months (p less than 0.05). After 6 months patients who had undergone PTCA functioned better at work (p less than 0.005), in sexual performance (p less than 0.0001) and with their families (p less than 0.002). The improvement in work functioning continued at 15 months (p less than 0.04), but the differences in sexual and family domains became nonsignificant.

Adaptation, Psychological↗
PubMed1984

Symptom complaints and health care seeking behavior in subjects with bowel dysfunction.

A significant proportion of the population (14%-22%) appears to have symptoms compatible with the irritable bowel syndrome, yet only a small number seek medical aid. To explore why some people with bowel dysfunction go to the doctor and others do not, we surveyed 566 healthy subjects. Eighty-six (15%) had bowel dysfunction compatible with irritable bowel syndrome, but the majority of those affected (53 subjects or 62%) had never been to a doctor for these complaints. Although those who consulted physicians for bowel symptoms were more likely to report abdominal pain than those who did not, pain was not sufficient to explain doctor visits. Subjects with bowel dysfunction also reported more nongastrointestinal symptoms, and those with bowel dysfunction who visited physicians were more likely to see physicians for their nongastrointestinal symptoms. The reported higher prevalence of psychopathology among the patient population with irritable bowel syndrome may be due to behavioral influences that lead to health care seeking.

Abdomen↗
PubMed1982

Intellectual functioning in renal failure and chronic dialysis.

The research literature on intellectual functioning in uremia and maintenance hemodialysis for renal failure is critically reviewed. The most frequently assessed neuropsychological functions have been general intelligence, memory, and attentional processes. Studies have consistently found lowered performance IQ scores compared to verbal IQ scores in renal failure patients prior to dialysis onset, suggesting the presence of intellectual deficit due to cortical dysfunction. The role of intelligence in adjustment to dialysis has not been clearly explicated, due in part to methodological variations among studies. Several studies point to significant improvement in short-term memory both after onset of maintenance dialysis and from one day before to one day after an individual dialysis treatment session. Attentional functions appear to improve after onset of dialysis treatment as well, but small sample sizes limit the conclusiveness of the data on these cortical processes. Future research efforts should be aimed at correlating physiologic with neuropsychological data and at longitudinal study of intellectual functioning in dialysis patients.

Attention↗
PubMed1982

Longitudinal study of neuropsychological functioning in patients on chronic hemodialysis: a preliminary report.

This study is part of a five-year project to investigate the long term effect of chronic hemodialysis on patients with end-stage renal failure. Previous research has associated hemodialysis with progressive dialysis encephalopathy (PDE), which is characterized by speech disturbances, cognitive impairment, myoclonus and behavioral changes. Little is known about the cause or the course of this syndrome except that it begins 14-36 months after treatment onset and usually culminates in death. The purpose of this study was to investigate neuropsychological (cognitive and behavioral) functioning in dialysis patients over a period of years. To date, 34 patients have been studied for 22 months utilizing a cross-sectional method comparing patients at different stages of treatment combined with a longitudinal method of repeated evaluations over time. Current findings show improved cognitive functioning during at least the first year of treatment and no evidence of cognitive deterioration in patients on dialysis for more than one year (M = 4.3). These findings offer strong evidence that PDE is not necessarily a general phenomenon among patients on chronic hemodialysis.

Brain Diseases↗
PubMed1982

The MMPI as a measure of the emotional correlates of chronic hemodialysis: a review.

The MMPI has been the most frequently used objective personality measure in studies of the emotional correlates of chronic hemodialysis for end-stage renal failure. This paper reviews MMPI findings of these studies and examines the utility of this instrument with chronic dialysis patients. Overviews of the basic research strategies employed and of the methodological shortcomings of the published studies are presented. Research findings are reviewed, and pros and cons of using the MMPI with this population are briefly discussed. The most consistent finding to date has been elevation in the "neurotic triad" (scales 1, 2, and 3), but the meaning of this configuration for dialysis patients is ambiguous.

Affective Symptoms↗
PubMed1982

Bowel patterns among subjects not seeking health care. Use of a questionnaire to identify a population with bowel dysfunction.

To understand the disorders of bowel motility, it is important to know the range of bowel patterns in the general population. We have devised a brief self-administered questionnaire which, when used among a group of 789 students and hospital employees, disclosed that 94.2% had stool frequencies between three per day and three per week, and that 17.1% had bowel dysfunction. When compared with the remaining sample, the bowel dysfunction group was predominantly female. This group also reported more often that stress influenced their bowel function, and more often used laxatives and visited physicians for bowel complaints. Further medical evaluation to characterize this subgroup is needed. We believe that selection, for psychologic and physiologic study, of subjects with bowel dysfunction not seeking health care will provide a needed comparison group in our understanding of patients with irritable bowel syndrome.

Adult↗